Trendowski Matthew R, Ruterbusch Julie J, Baird Tara, Kyko Jaclyn M, Martin Jennifer L, Schwartz Ann G, Markey Grace E, Badr M Safwan, Beebe-Dimmer Jennifer L
Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R Mailcode: MM04EP, Detroit, MI, 48201, USA.
Geriatric Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
J Cancer Surviv. 2024 Mar 20. doi: 10.1007/s11764-024-01568-5.
Sleep disturbances represent a modifiable target to improve quality of life and longer-term outcomes in cancer survivors. However, the association between sleep health and overall quality of life in African American cancer survivors has been poorly assessed, a population at increased risk for morbidity and mortality.
Seven hundred and eighteen Detroit Research on Cancer Survivors (ROCS) cohort participants completed a supplemental sleep survey at the time of enrollment, which included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI). Linear and logistic regression was used to evaluate the association between sleep and mental health, while block regression models were used to estimate the contribution of clustered factors to Health-Related Quality of Life (HRQOL).
Nearly 60% of the cohort reported symptoms indicative of poor sleep quality on the PSQI, 15% reported excessive daytime sleepiness on the ESS, and 12% reported moderate to severe insomnia on the ISI. Survivors with elevated ISI scores reported FACT-G scores that were 17 points lower than those without symptoms of insomnia (95% CI: - 13.1, - 21.2). Poor sleep health accounted for the largest proportion of variability in FACT-G scores (R = 0.27) and change in R value (0.18) when compared to comorbidities, health behaviors, cancer-related factors, and demographics.
Overall sleep health was significantly associated with poorer HRQOL and variability in FACT-G scores. Additional studies investigating a causal relationship between sleep and HRQOL are needed to determine whether sleep quality could affect disparities in cancer outcomes.
Addressing sleep quality in cancer survivors may improve long-term health and HRQOL.
睡眠障碍是改善癌症幸存者生活质量和长期预后的一个可调节目标。然而，非裔美国癌症幸存者的睡眠健康与总体生活质量之间的关联尚未得到充分评估，这一人群的发病和死亡风险有所增加。
718名底特律癌症幸存者研究（ROCS）队列参与者在入组时完成了一项补充睡眠调查，其中包括匹兹堡睡眠质量指数（PSQI）、爱泼华嗜睡量表（ESS）和失眠严重程度指数（ISI）。采用线性和逻辑回归评估睡眠与心理健康之间的关联，同时使用逐步回归模型估计聚类因素对健康相关生活质量（HRQOL）的贡献。
近60%的队列参与者在PSQI上报告了表明睡眠质量差的症状，15%的人在ESS上报告了白天过度嗜睡，12%的人在ISI上报告了中度至重度失眠。ISI得分升高的幸存者报告的FACT-G得分比没有失眠症状的幸存者低17分（95%CI：-13.1，-21.2）。与合并症、健康行为、癌症相关因素和人口统计学相比，睡眠健康状况不佳在FACT-G得分的变异性中占最大比例（R=0.27），R值变化为0.18。
总体睡眠健康与较差的HRQOL和FACT-G得分变异性显著相关。需要进一步研究睡眠与HRQOL之间的因果关系，以确定睡眠质量是否会影响癌症预后的差异。
解决癌症幸存者的睡眠质量问题可能会改善长期健康和HRQOL。
